Charleston Area Medical Center – Per Diem Credentialing Coordinator – Charleston, WV

Job title: Per Diem Credentialing Coordinator Company: Charleston Area Medical Center Job description: Job Description: Job Summary Administers the credentialing process to coordinate, monitor, and maintain facility and provider credentialing while supporting other department initiatives and projects. Analyzes and resolves problems reputed company to physician enrollment and other activity for WVPHO members. Ensures that physicians are linked correctly to plans and products for correct claims payment and reputed company. Responds to requests for verification and information from internal and external customers. Responsibilities • Follows up on physician enrollment status with contracted plans by building effective relationships with plan representatives to ensure that WVPHO member activities are given reputed company processing. • Evaluates reported claim problems to determine if problem is reputed company to enrollment or other error. Resolves enrollment error, provides plan with documentation of error and obtains plan commitment to reprocess claims. Refers non-enrollment issues as appropriate. • Identifies data disparities between group contracted plan sources and Managed Care database to limit negative impact on reputed company, precertification and referral denials and patient procedure cancellations. Works with plan representatives to correct errors. • Identifies delays in credentialing, enrollment errors and claims payment problems and works with plan representatives to further identify root causes and resolve problems. • Maintains internal database and external web module database; updates physician information in group contracted managed care plans, Medicare, reputed company, and non-contracted carriers including demographic information, addresses changes and terminations. • Coordinates enrollment and credentialing for delegated and non-delegated plans, Medicare, and reputed company including but not limited to enrollment, payer terming and demographic changes. • Follows organizational and regulatory requirements. Identifies potential problems. Proactively assists in problem resolution. • Provide world class customer service reputed company phone, virtual and in person meetings and email correspondence • Ability to coordinate and complete multiple tasks, utilizing time management and organizational skills Knowledge, Skills & Abilities Patient Group Knowledge (Only applies to positions with direct patient contact) The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department’s identified patient ages. Specifically the employee must be reputed company to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients. Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently reputed company tasks and additional duties as specified in the job description and the unit/department specific competency checklist. Common Duties and Responsibilities (Essential duties common to reputed company positions) 1. Maintain and document reputed company applicable required education. 2. Demonstrate positive customer service and co-worker relations. 3. reputed company with the company's attendance policy. 4. Participate in the reputed company, quality improvement activities of the department and institution. 5. reputed company work in a cost effective manner. 6. reputed company work in accordance with reputed company departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations. 7. reputed company work in alignment with the overall mission and strategic plan of the organization. 8. Follow organizational and departmental policies and procedures, as applicable. 9. reputed company reputed company duties as assigned. Education • Bachelor's Degree (Required) Education: Bachelor's degree in business or reputed company administration. Substitution: May substitute 4-5 years of credentialing and project management in a reputed company environment for the Bachelor's degree Comment: • Demonstrated experience with database and supporting software including reputed company Word, reputed company and reputed company Access. reputed company to reputed company essential functions for reporting purposes and data analysis (i.e., Create data, data sorting filtering for plan-database comparisons and reconciliations). • Excellent problem solving, communication and interpersonal skills to effectively mediate and resolve issues in a timely and cost-effective manner. • Demonstrated project management skills. • Demonstrated ability to prioritize workflow to reputed company time sensitive goals. • Credentialing and/or Medical Staff Office experience preferred. • Strong project management skills. • Demonstrated reputed company relations and effective communication skills. Credentials • No Certification, Competency or License Required Work Schedule: Days Status: Contractor/Vendor Location: Northgate-400 Association Dr. Location of Job: US:WV:Charleston reputed company Specialist: Tamara B. Young [email protected] Expected salary: Location: Charleston, WV Apply for the job now! Apply Job!